Renal function in patients with Wilms tumor

Romao, Rodrigo; Lorenzo, Armando J.

doi:10.1016/j.urolonc.2015.07.002

Cited by 28 publications

(29 citation statements)

References 35 publications

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“…Prophylactic nephrectomy and gonadectomy are recommended for patients at a high risk of developing Wilms tumor and gonadoblastoma respectively [10][11][12][13]. However, the issue of prophylactic nephrectomy is still debatable, and some authors [14,15] recommend considering nephron-sparing surgery in patients without end-stage renal disease (ESRD) who develop Wilms tumor to delay the onset of renal failure.…”

Section: Introductionmentioning

confidence: 99%

Genotype–phenotype analysis of pediatric patients with WT1 glomerulopathy

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Genotype–phenotype analysis of pediatric patients with WT1 glomerulopathy

et al. 2016

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“…Romao et al (15) suggests that patients with hereditary predisposition syndromes who develop UWT should be treated with preoperative chemotherapy followed by nephron-sparing sur- Within the NWTS 4, 23 out of 188 (12%) patients with bilateral disease followed from 1986 to 1994 developed ESRD (18). According to Lange et al (9) who studied ESRD in non-WT1-syndromic patients treated by NWTS, the incidence of ESRD increased dramatically 20 years after diagnosis, reaching 3.1% for BWT.…”

Section: End-stage Renal Disease In Wtmentioning

confidence: 99%

“…Two main molecular subgroups are recognized: syndromes associated with germline WT1 mutation and overgrowth syndromes associated with epigenetic alterations in chromosome 11p15 (15,16).…”

Section: End-stage Renal Disease In Wtmentioning

confidence: 99%

“…Partial nephrectomy for patients with UWT is a more controversial topic, particularly in the case of excellent oncologic outcomes with unilateral radical nephrectomy. The risk of local recurrence, need for therapy intensification, and unclear long-term renal function benefits have been the basis for debate against NSS in the treatment of unilateral non-syndromic WT (15). NSS is necessary in patients with BWT for the preservation of nephrons and renal function (17, 18).…”

Section: Chronic Kidney Disease In Wtsmentioning

confidence: 99%

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Chronic Kidney Disease in Wilms Tumour Survivors – What Do We Know Today?

Stefanowicz

Kosiak

et al. 2016

Wilms Tumor

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Licence: This open access article is licensed under Creative Commons Attribution 4.0 International (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Users are allowed to share (copy and redistribute the material in any medium or format) and adapt (remix, transform, and build upon the material for any purpose, even commercially), as long as the authors and the publisher are explicitly identified and properly acknowledged as the original source. AbstractCurrently, the treatment of Wilms tumour (WT) is successful in approximately 90% of cases, and consists of chemotherapy, nephrectomy, and, in some cases, radiation therapy. All treatments have potential long-term influence on the function of solitary kidneys in WT survivors (WTS). Severe reduction in glomerular filtration rate occurs after nephrectomy. All patients who underwent surgical treatment for WT could be considered to have 132a risk of chronic kidney disease (CKD) because they lack a kidney. End-stage renal disease is rare (1.8% of National Wilms Tumour Study patients). Recent studies have revealed that patients with CKD have a greater risk of cardiovascular events and death. Most of the WTS have lower stages or no CKD. Regular biochemical studies and ultrasound examination at follow-up visits should be considered as indispensible elements of long-term care in uninephrectomized WTS. The evaluation of a single kidney function should be frequent, consisting of the assessment of estimated glomerular filtration rate (eGFR), assessment of albumin urine excretion, urine sediment analysis to detect abnormalities, ultrasound examination and measurements of blood pressure. According to Kidney Disease Improving Global Outcomes (KDIGO) recommendation and suggestions, GFR should be assessed using GFR-estimating equations that include serum creatinine and cystatin C concentrations. Cystatin C can be a more sensitive marker of kidney filtration function than creatinine, especially in diseases characterized by a mild decrease in glomerular filtration. This will facilitate the detection of early kidney impairment and assessment of the progression of CKD in WTS.

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“…Although a relatively small figure, it reflects an incidence that is eightfold higher than that expected in the age-matched general population 17, 18 . Patients who previously underwent a RN are at risk of presenting a trend towards progressive decline in eGFR with aging 20, 21 . Conversely, patients who underwent NSS appear to have a more favorable trend with preserved eGFR up to the third decade of life 20– 23 .…”

Section: Long-term Treatment Effectsmentioning

confidence: 99%

Recent advances in the management of Wilms' tumor

Lopes

Lorenzo

2017

F1000Res

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The objective of this article is to present an overview of recent trends in the management of Wilms’ tumor. With improved survival rates in the past few decades, critical long-term adverse therapy effects (such as renal insufficiency, secondary malignancies, and heart failure) and prevention measures (i.e. nephron-sparing surgery and minimizing the use of radiotherapy) have gained worldwide attention. Specific disease biomarkers that could help stratify high-risk from low-risk patients, and therefore fine-tune management, are in great demand. Ultimately, we aim to enhance clinical outcomes and maintain or improve current survival rates while avoiding undesirable treatment side effects and minimizing the exposure and intensity of chemotherapy and radiotherapy.

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Renal function in patients with Wilms tumor

Cited by 28 publications

References 35 publications

Genotype–phenotype analysis of pediatric patients with WT1 glomerulopathy

Genotype–phenotype analysis of pediatric patients with WT1 glomerulopathy

Chronic Kidney Disease in Wilms Tumour Survivors – What Do We Know Today?

Recent advances in the management of Wilms' tumor

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